Getting GentleCure (IM-SRT) for my 2 Basal Cell Carcinomas

I have basal cell carcinoma on one side of my nose. About an inch long that looks like a scar and has been there for years. After they did a biopsy, it started spreading while I looked for a MOHS surgeon. A friend told me about Gentle Cure, and I signed up for it. The doctor did not tell me about any down sides to the treatment, and now I am reading that scars can occur and that fatigue is often associated with treatment. The whole reason why I choose Gentle Cure treatment was to AVOID scarring! Should I be concerned? Is there anything I should be doing or asking? Beyond stressed.

@cw17: Welcome to Mayo Clinic Connect where several people have experienced similar situations as you are going through, including myself.

I have had several BCCs, SCCs - even melanoma - over the years. I once opted for radiation although I'm uncertain if it was called Gentle Cure, when I had a BCC near my eye; several visits to the radiologist over a period of weeks, no real down time or appreciable side effects except for maybe some scaling/redness and needed to take basic precautions when out in the sun. It must have worked well as I have no scarring in that area!

As for pros/cons: You are correct that radiation is less likely to leave any type of scarring; some skin discoloration may be possible. No incisions are required. It does, however, require multiple sessions and there is no sure fire way to assess all margins are clear. Mohs does remain the gold standard to ensure all margins are clear; it is performed in one session. To my knowledge, and in my experience, neither has resulted in any associated fatigue.

Why had your doctor not informed you of this option? Possibly because it is not offered in office. Have you inquired about the treatment with them to get their perspective?

@bhintz777 Hi, yes, I did Gentle Cure on both my spots above my upper lip and below my nose. I have no scars now and I’m happy! But, I’m a super sensitive person and the radiation did affect me, my energy waned, I felt dizzy at times, and it affected my immune system And thyroid. But, I’m also post-menopause, post-hysterectomy, post-appendectomy and post Covid survivor (4x), so maybe you’ll be just fine! I would recommend drinking lots more water, take immune supplements like Airborne, Vit C, magnesium, zinc, eat lots of fruits and veggies, lean proteins, complex carbs, you’ll do great!!! Hope this helps, let me know if you have more questions! It doesn’t hurt at all, and they let me hold my favorite teddy bear every time!! I did have to use a tooth guard, and have them use a new one each time, they reused the one I had each time for 15 sessions and it caused me to have two UTI’s and a kidney infection in the hospital, so change it each day!! Sending you healing ❤️‍🩹 blessings and keep me posted!!! 🙏🙏❤️❤️🙏🙏 Mia 😊😍

@pianist3 Oh my goodness! I do see your post was from AUGUST! I'm not sure why I responded as if it was new - forgive me, but I'm sure glad to hear you had such a positive outcome!

@cw17: Welcome to Mayo Clinic Connect where several people have experienced similar situations as you are going through, including myself.

I have had several BCCs, SCCs - even melanoma - over the years. I once opted for radiation although I'm uncertain if it was called Gentle Cure, when I had a BCC near my eye; several visits to the radiologist over a period of weeks, no real down time or appreciable side effects except for maybe some scaling/redness and needed to take basic precautions when out in the sun. It must have worked well as I have no scarring in that area!

As for pros/cons: You are correct that radiation is less likely to leave any type of scarring; some skin discoloration may be possible. No incisions are required. It does, however, require multiple sessions and there is no sure fire way to assess all margins are clear. Mohs does remain the gold standard to ensure all margins are clear; it is performed in one session. To my knowledge, and in my experience, neither has resulted in any associated fatigue.

Why had your doctor not informed you of this option? Possibly because it is not offered in office. Have you inquired about the treatment with them to get their perspective?

@grammato3 No one except a friend told me about Gentle Cure. There is only one place in my state where it is offered. But what concerns me now is the chance that it will leave a bleached mark on the side of my nose. The area of the cancer is about one inch long and about 1/4 wide. Reading these comments made me aware of this possibility as the Gentle Cure doctor never mentioned that. So to me, a white mark is still a scar. Maybe I'd be better off with MOHS and then plastic surgery??

@cw17: I see what happened now - I'd meant to respond to YOU yesterday and somehow wound up replying to our old friend @pianist3, which turned out to be a good thing because she's provided some helpful information!

At any rate, please accept my delayed welcome and let's see if we can delve a bit deeper into some of your concerns.

As to which procedure to undergo, this choice is entirely up to you and you're doing the right thing by asking questions about the two: Mohs vs Gentle Cure. It helps to research the pros and cons and of course discuss with your medical provider. You may want to ask why was Mohs decided upon rather than the radiation option you've learned about. Is this a basal or squamous cell cancer that would require being absolutely sure of the depth and margins? Is it recurrent? In such cases, a provider may have a preference to do Mohs.

You noted the concern about skin discoloration. Was it on this forum that you'd read about the possibility of Gentle Cure leaving a bleached or white mark on the area that would be treated? I am honestly not familiar with that as most areas treated by such type of radiation typically have temporary changes in skin color (if at all) while undergoing treatment and perhaps for a few weeks afterwards. I have not read any conclusive evidence of a permanent bleached type of result.

You also noted there is only one location in your state that provides the Gentle Cure option so you'd need to be sure you're within a distance that would allow for several visits over a period of weeks, sometimes up to 3x for 7 weeks or so.

I can understand that with the location and size of the skin cancer being on your nose, there is a valid concern about what the cosmetic effect would be. When I'd had a wide local excision (WLE) for an advanced skin cancer (melanoma) I had required some reconstruction of adjacent skin that typically isn't the case with Mohs and the scar was initially quite alarming to me - but it has faded considerably over time, aided by 2 laser sessions. The Mohs procedures I've had, and there have been numerous ones I'm afraid, have honestly not left any noticeable scars as most dermatologists are quite adept at closure. This, again, is something you may want to discuss in greater detail with your provider, i.e. would plastic surgery or any other type of related interventions be necessary at a later date.

Has this background provided a basis to help you explore or make your decision any easier?

@cw17: I see what happened now - I'd meant to respond to YOU yesterday and somehow wound up replying to our old friend @pianist3, which turned out to be a good thing because she's provided some helpful information!

At any rate, please accept my delayed welcome and let's see if we can delve a bit deeper into some of your concerns.

As to which procedure to undergo, this choice is entirely up to you and you're doing the right thing by asking questions about the two: Mohs vs Gentle Cure. It helps to research the pros and cons and of course discuss with your medical provider. You may want to ask why was Mohs decided upon rather than the radiation option you've learned about. Is this a basal or squamous cell cancer that would require being absolutely sure of the depth and margins? Is it recurrent? In such cases, a provider may have a preference to do Mohs.

You noted the concern about skin discoloration. Was it on this forum that you'd read about the possibility of Gentle Cure leaving a bleached or white mark on the area that would be treated? I am honestly not familiar with that as most areas treated by such type of radiation typically have temporary changes in skin color (if at all) while undergoing treatment and perhaps for a few weeks afterwards. I have not read any conclusive evidence of a permanent bleached type of result.

You also noted there is only one location in your state that provides the Gentle Cure option so you'd need to be sure you're within a distance that would allow for several visits over a period of weeks, sometimes up to 3x for 7 weeks or so.

I can understand that with the location and size of the skin cancer being on your nose, there is a valid concern about what the cosmetic effect would be. When I'd had a wide local excision (WLE) for an advanced skin cancer (melanoma) I had required some reconstruction of adjacent skin that typically isn't the case with Mohs and the scar was initially quite alarming to me - but it has faded considerably over time, aided by 2 laser sessions. The Mohs procedures I've had, and there have been numerous ones I'm afraid, have honestly not left any noticeable scars as most dermatologists are quite adept at closure. This, again, is something you may want to discuss in greater detail with your provider, i.e. would plastic surgery or any other type of related interventions be necessary at a later date.

Has this background provided a basis to help you explore or make your decision any easier?

@grammato3 Thanks for the good notes. I had Mohs one week ago for basal cell down the top of my nose, incision is healing up ok. There is a bump at the top of the 2” long incision, not sure why. Surgeon said I am allergic to the Rx cream and changed it. Two additional places on back and shoulder excised seem to be doing OK. Breast cancer found the same week as my Mohs, upcoming BC surgery in two weeks. BRCA1 and 2 both negative, but unknown variant in TP53 gene. Anyone else with both? Thanks